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In order to thwart the trend of high-cost care for lower quality and improve our health knowledge, we must broaden our critical thinking abilities
Perhaps you've noticed this disturbing trend. We spend more and more on increasingly elaborate schemes but seem to get less in return for the effort and expense. We spend the most (it is said) of any country on healthcare but get poorer results that other developed countries. We spend billions on defense yet we seem to be constantly at war and fear attack from all quarters. Education spending (based on per capita GDP) is at the high end internationally, yet the population as a whole is woefully under-educated. Those who graduate have significant deficits in both knowledge and critical thinking skills.
Those who don't graduate are left even more impaired. Not surprisingly, these same individuals lack basic knowledge about health. Koh and Rudd opine that, "It is a troubling paradox. In the midst of rapid expansion of medical knowledge intended to benefit many, too few actually understand medical information well enough to improve their health."
When people don't know enough to reason their way through a complex problem, or lack the critical thinking skills needed to apply what they know, it makes them defensive. They feel under attack by those who think differently and may come to see them as sub-human. In the mid-1500s, Michell de Montaigne [http://www.luminarium.org/renascence-editions/montaigne/index.htm] noted a similar reaction to an unfamiliar culture: "I finde (as farre as I have beene informed) there is nothing in that nation (referring to a society that engaged in ritual cannibalism) that is either barbarous or savage, unless men call that barbarisme which is not common to them." The safest response is to take refuge in beliefs. After all, beliefs require no knowledge or thought, only acceptance and faith. For those fortified by belief, constructive dialogue becomes impossible.
Luckily, there is something that each of us can do to become part of the solution rather than part of the problem. We can broaden and deepen our knowledge base and improve our critical thinking abilities. I do this by reading a diverse assortment of books. Starting with this article, I'm going to describe some of the ones that I have found especially interesting and useful.
You have probably heard, or used, the expression "think outside the box," when a problem wasn't yielding to the usual approach, but sometimes a different perspective, one that abandons some of the usual assumptions, allows for a new formulation in which the formerly impossible becomes possible. Another word for this kind of box is paradigm. Anyone whose work is heavily influenced by a paradigm, or who is involved in attempting something novel (changing the paradigm), has hopefully read Thomas Kuhn's "The Structure of Scientific Revolutions." It was first published in 1962. It has been revised several times since and a 50th Anniversary edition was released in 2012.
The influence that this little book has had in incalculable. It altered the discussion in a myriad of fields. Recognizing that a paradigm is exerting an influence is the first step to assessing its continuing value.
For centuries, categorization and classification of objects has been conducted under the Platonic Paradigm, which holds that actual objects are realizations of absolute, ideal forms and that anyone from any culture, encountering an object, will perceive it in the same way, because of these intrinsic properties. Cognitive science is one of the fields that has suggested that there is nothing "intrinsic" or "absolute" about the way different peoples perceive objects.
Categorization and classification are relative to the cultural and linguistic frames of reference of those doing the categorizing. The title of George Lakoff's "Women, Fire, and Dangerous Things" was inspired by the Dyirbal language (an Australian Aboriginal language), in which the "feminine" category includes nouns for women, water, fire, violence, and certain animals. It should be required reading for anyone who is involved in devising schemes of coding or classification or, for that matter, anyone who would like to get a better understanding of why "progressives" and "conservatives" have so much trouble understanding each other.
More next time.